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Within the next three months, Orlando-area hospitals will begin the first phase of a project to share medical records from hospitals to area doctors. Doctors won’t be able to send records back to the hospitals, but they will have a secure Web site that allows access to the medical records of their patients that were generated by any of the participating hospitals.

This first phase – known as a “push” model for the way hospitals push the information out – costs $500,000, not including the millions of dollars spent individually by hospital systems in establishing their own electronic medical records. The organization in charge with the collaboration received $700,000, including local investment and $200,000 from the state.

A completely shared exchange system between all Orlando providers will likely cost around $3.8 million.

Central Florida lags slightly behind other regions in sharing EMRs. In Tampa, three pilot projects are on the way, one already completed, that allows the two-way sharing of information between multiple providers, such as pharmacists, doctors, hospitals and freestanding imaging centers.

“It’s safe to say that things are progressing nicely,” said Becky Cherney, chairwoman of the Central Florida Regional Health Information Organziation. “The key is working on fundraising to work on the next level.”

That’s not to say hospitals themselves haven’t spent a fortune on electronic records. Florida Hospital spent $100 million on its computer system over three years moving to a completely paperless record-keeping, said Andy Crowder, senior vice president and chief information officer.

“Our own systems had to be in place before we started sharing information,” Crowder said.

Florida Hospital, too, has already created a system where its own doctors, some 2,500 of them in the community, can access records over a secure Internet connection. The next phase is simply extending that access to all doctors, pharmacists and lab technicians.

Working between healthcare providers has been encouraging, but the funding issues are still tough when it comes to raising money from the business community, said Crowder.

“Trying to explain to community leaders and employers the benefit is hard
sometimes,” Crowder said. “Trying to drill down on benefit is a difficult sort of thing to figure out. In theory it should reduce lab tests and other unnecessary services.”

Nationally, the value of an electronic health record exchange has been estimated at nearly $80 billion a year once fully implemented.

“Studies have shown that if a hospital looked at the cost of what they spent on staff, sending faxes and couriers and FedEx, if they had that money, the savings would pay for so many other services,” Cherney said.

The legislature has for the past several years recognized the value of sharing medical records between doctors. It created a grant program in which seven separate organizations across the state have participated. In 2005-06, it gave $1.5 million; in 2006-07 $2 million. But in 2008-09 there is no state funding.
“To me, this next year will really be the test for who can be most innovative and figure out a funding niche,” said Caroline Turner, who administers the grant program for the state. “People have different ideas. Everybody has the same vision of the end game, but people are working on different ways on how to get there.”

Turner said given the tough budget year, more emphasis would likely be placed on physician adoption. Right now somewhere between 15 and 30 percent of Florida doctors have an EMR system depending on how it’s defined. Some doctors have electronic records for only certain parts of the complete patient record.

There are many ways to be innovative in sharing health records once the capability exists. Some have thought of a computer flash drive with a medical record stored on it that people could keep on their key chain.

Ernie Clevenger, an entrepreneur who started Tennessee-based CareHere, an administrator of on-site health clinics, envisions cell phones as the personal storage device for personal health records. It has an electronic format and can be easily connected to the Internet.

“As our baby boomers grow and we seek to stay at home, there will be a growth of devices that allow us to monitor in real time our health status,” Clevenger said. “Do you go to a doctor or does the doctor come to you? If cell phones held medical records, think of possibilities if a camera could take a snapshot of a wound and send it to the hospital before you get there.”



July 2008

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